Department of Nephrology and Renal Replacement, Daido Hospital, Japan.
Department of General Internal Medicine, Shonan Kamakura General Hospital, Japan.
Intern Med. 2020 Sep 1;59(17):2191-2195. doi: 10.2169/internalmedicine.4676-20. Epub 2020 May 26.
A 72-year-old lady with atrial fibrillation and chronic renal failure was hospitalized due to bradycardic shock with electrocardiographic QRS prolongation. She had experienced limb shaking two days before hospitalization, and additionally developed hallucinations one day before admission. Pilsicainide intoxication was diagnosed from a review of her medications and electrocardiographic findings. Consequently, continuous hemodiafiltration was performed resulting in a resolution of the hallucinations and the QRS prolongation. This is a rare case of psychiatric symptoms caused by pilsicainide intoxication. It is important to know the mode of excretion of a drug and to adjust its dose, so that such drug-related incidents can be avoided.
一位 72 岁的女性，患有心房颤动和慢性肾衰竭，因心电图 QRS 延长伴心动过缓性休克住院。她在住院前两天出现肢体震颤，入院前一天出现幻觉。根据她的用药和心电图检查结果，诊断为吡西卡尼中毒。随后进行了连续性血液透析滤过治疗，幻觉和 QRS 延长得到缓解。这是一例由吡西卡尼中毒引起的罕见精神症状病例。了解药物的排泄方式并调整剂量非常重要，这样才能避免此类药物相关事件的发生。
